Vets/Experts here,MBD diagnosis-need help understanding the bloodwork numbers PLEASE

Guaca mole

Guaca mole

Member
"Hemolysis index 0
Lipemia index 0
Glucose 319
Calcium 10.9
Phosphorus 17.5
Uric Acid 3.1
Total protein 7.2
AST 286
LDH 896
CPK 4731 (value obtained by dilution)
Alkaline Phosphatase 71
GGT <5

Estimated WBC 2-4 x 10.3 (unit of measure?)
The unopette count was low so a slide estimate was done

Red Blood Cell Count 1.35 x 10.6 (unit of measure?)
Hematocrit 29
Heterophils 76
lymphocytes 24
Azurophils/Monocytes 0
Eosinophils 0
Basophils 0
RBC Morphology Mild Polychromasia
Blood Parasites Negative
Thrombocyte Morphology Normal
WBC Morphology See comment

The majority of lymphocytes observed in the differential were large lymphocytes. This may be indicative of an active immune system response."

Not sure why the PDF files of these will not upload the attachments, had to type them in manually.

I know that the elevated phosphorus levels are bad, as that is a sign of kidney failure.
What are the normal ranges versus his and are there any other numbers that I should be concerned about?
 
The bloodwork is consistent with MBD. The phosphorus level should be ideally twice as high as the calcium level. The uric acid level is still low, which is good. Phosphorus elevates when there is adequate calcium and/or UVB to cause deficiency. It can also happen with kidney failure but there's not enough info to say which one in this case.

I need a little bit more information to help correlate the numbers with the clinical presentation. Please copy and paste this form (https://www.chameleonforums.com/how-ask-help-66/) and fill out the answers to provide more information on your cham and setup. Good pictures of your cham would be very helpful! What symptoms led to you taking your cham to the vet for bloodwork to begin with?

Here is more information on MBD and how it is treated. https://www.chameleonforums.com/wha...ase-mbd-looks-like-how-happens-how-fix-95071/
 
Chameleon Info:
Your Chameleon - Male Veiled Chameleon, age unknown. Sold as 'juvenile' so by my guesstimation maybe 3-6 months? Measures 5" nose to back feet and 5" of tail. I have had him for a little over a month now (purchased January 12th)

Handling - Just about every day, when he wants out I let climb onto my hand. He is very friendly and loves to be out of his cage. I have a hard time getting him back in there for bedtime most nights.

Feeding - I feed him 2x a day, spaced 8 hours apart. 4 crickets, 4 small Superworms, 2 waxworms and various small pieces of fruits and veggies (trying to figure out what he likes) Apples, strawberries, mangos, bananas, carrots, cucumbers, green pepper, red pepper, alfalfa sprouts. I feed the crickets the Flukers orange cubes and Flukers Cricket Quencher (calcium fortified) and gutload them with organic baby food and whatever leftover fruits and veggies that he does not eat. He was skinny when I bought him and has a voracious appetite.
*** I have gotten rid of the Flukers orange cubes and have been feeding the crickets with Cricket Crack, gutloading with organic baby food and fresh organic veggies***

Supplements - Repticalcium w/o D3 on 4 of the crickets, once a day and Repticalcium with D3 2X a week (on 4 of the crickets) substituted on the days that the Repticalcium w/o is not given. Exo terra Multivitamin 2X a month.
***I have changed his calcium supplementation to calcium w/o D3 every feeding and he will get calcium with D3 2 X a month.***

Watering - I use a sprayer to mist the plastic plants 3 X per day, get them coated with small droplets of water, enough to let them run down. I let them dry completely between mistings. The 'Lil dripper' is running while I am at work. I have seen him drinking but he seems sort of shy about it now. I just received the Nature Zone watering vine and hooked it to the end of the Lil Dripper last night. I bought a gerbil water bottle and he was able to work it, he likes the shiny element of the ball end. I removed it when I saw him bite it, not sure if he could hurt himself?

Fecal Description - Once a day, like clockwork. Usually pretty large (legnthwise) and the diameter of a pencil. Urates are white with a glob of yellow and has some egg while looking gel surrounding them. He has not been tested for parasites or seen by a vet. He holds his leg out to the side like a dog does when he "goes" I have seen his hemipene pop out once and it went back once he was finished his business.

History - Purchased from PetSmart, my friend said that he looked healthy considering it was from a chain pet store. I work nights and have him on my schedule (days and nights opposite of the rest of the world) His morning is at 6PM and his bedtime is at 6AM. I have light blocking panels in our bedroom and 3' thick styrofoam sound barrier (I live across the street from a VERY boisterous elementary school, awesome when you work nights! *sarcasm*)

Cage Info:
Cage Type - Small sized Reptibreeze screen cage, 16 X16 X20
***purchased new "big boy" cage, Large Reptibreeze screen cage 18 X 18 X 36***

Lighting - Reptisun 5.0 HO terrarium hood light (fluorescent strip looking model) and a ZooMed mini combo deep dome (dual fixture) with a ZooMed 50w Repti Basking spotlight on for 12 hours (also while the UVB is on) and 12 hours of a blue 50 W night heat lamp, run on a ZooMed 12 hour day/night timer.
***Got rid of the night light het bulb and replaced it with a 60w ceramic heat emitter. Upped the basking bulb to 75w basking spotlight (to up the cage basking spot temp to 90 degrees as recommended by my vet) I have also purchased a 100w SB Mega Ray mercury vapor bulb for his big boy cage***

Temperature - 75 degrees on the bottom of the cage floor and 85 at basking spot. Lowest overnight temp would 75 degrees at the cage bottom (my AC is set to 75 degrees in my condo) Monitored by an All Living Things digital thermometer/ hygrometer. Bottom cage thermometer is a strip thermometer for an aquarium.
***Daytime temp basking spot is now 95 degrees, nighttime top of the cage temp is 85 degrees as recommended by my vet***

Humidity - 50% at lowest and 99% after mistings. I use a humidifier overnight for him, not sure what the % is while that is on, I need to look. Measured by the thermometer/ hygrometer combo.

Plants - Currently all plastic. I just bought a Schefflera, a hibiscus and a hanging pothos plant. I have not introduced him to them yet, I have also bought the organic soil but have not yet "un-dirted" them and rinsed off the roots or washed the plants to be able to introduce him to them. I had bought a fake moss carpet looking substrate but he tried to eat it so I never put it in his cage.
***Have thoroughly washed and repotted all three plants with organic dirt, with large river rocks covering the soil. Have added one collard green hanging in his cage to munch on. He eats about half of it, tears into it with vigor. Also eats hibiscus leaves when free ranging in it***

Placement - Cage is located in the corner of my bedroom, near my bed. It is away from the AC vents draft zone. I have one ceiling fan running on slow to keep the air flowing. Not really a high traffic area, as it is just me. I had the cage on a temporary stand and the top of the cage was about 4' from the ground then. I have since made it so the top is almost at 6' high.

Location - Miami/Ft Lauderdale, Florida

Current Problem - His tongue has not retracted on two separate occasions now (one that happened last night) It freaked both of us out. Not sure what is the cause but I am VERY concerned.

Here is the link to my original thread in the Health Clinic forum for the entire scenario.
https://www.chameleonforums.com/tongue-not-retracting-125413/
 
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Ok that all fits with MBD. A picture would still be helpful. As others mentioned in your other post gutloading shouldn't be an afterthought to whatever is left over, it should be a primary concern. You want to use high calcium veggies for the primary component of the gutload. The cricket quencher is fine to use for moisture but just throw out those orange cubes. They're terrible for nutrition and the crickets stuff themselves on those and don't eat the good stuff you put in. Baby food is also not a good thing to use regularly as it's formulated for humans and has a different nutrient profile than reptiles need.

Suggested Ingredients
Best - These gutloading ingredients are best because they are highest in calcium, low in phosphorus, oxalates and goitrogens. They should be the primary components of your gutload:
mustard greens, turnip greens, dandelion leaves, collard greens, escarole lettuce, papaya, watercress and alfalfa.

Good - These gutloading ingredients are good because they are moderately high in calcium and other vitamins/minerals. They should be used in addition to those from the previous category:
sweet potato, oranges, mango, butternut squash, kale, apples, beet greens, blackberries, bok choy and green beans.

You don't need to use the D3 cal more than twice a month. And make sure that neither of the calciums have phosphorus in them. You are lucky to live in Florida so if you can get him in natural sunlight as that is the best thing for him to recover from this. Also do start the liquid calcium supplementation your vet recommended. This more potent version helps replace the deficit and needs to be used in addition to the powder still to meet daily needs as well.
 
The tongue issue isn't surprising given the diagnosis. Calcium is vital not just in building bones but in running nerve impulses to the muscles. So when there isn't enough calcium in the diet the body will start to pull calcium out of the bones to run things like the brain, heart, digestive tract, etc. But that only lasts so long, so you start to see the muscles not work properly, like the tongue. That's why most chameleon with MBD will grab themselves by accident, misstep while walking, etc., because the nerve impulses are all wonky.

I would imagine that the tongue issue will resolve itself once blood calcium levels are back to where they should be.

Ferret is right, take advantage of the beautiful weather we're having here in Miami and get him outside if you can. Even if it's just 20-30 minutes a day, but the natural sunshine will do wonders for his health.
 
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